Is elevation of N-terminal pro-B-type natriuretic peptide at discharge associated with 2-year composite endpoint of all-cause mortality and heart failure hospitalisation after transcatheter aortic valve implantation? Insights from a multicentre prospective OCEAN-TAVI registry in Japan

Mizutani, Kazuki; Hara, Masahiko; Nakao, Mana; Okai, Tsukasa; Kajio, Keiko; Murakami, Takashi; Shibata, Toshihiko; Yoshiyama, Minoru; Naganuma, Toru; Yamanaka, Futoshi; Higashimori, Akira; Tada, Norio; Takagi, Kensuke; Araki, Motoharu; Ueno, Hiroshi; Tabata, Minoru; Shirai, Shinichi; Watanabe, Yusuke; Yamamoto, Masanori; Hayashida, Kentaro

doi:10.1136/bmjopen-2017-021468

Cited by 4 publications

(3 citation statements)

References 30 publications

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“…This was confirmed in our analysis showing elevated levels of NT‐pro BNP in patients with advanced DD compared to patients with normal or less advanced DD. Previous studies have shown that elevated NT‐pro BNP levels correlate with long‐term mortality in patients with severe AS after TAVR . Our study results are in line with these observations.…”

Section: Discussionsupporting

confidence: 92%

Impact of diastolic dysfunction on long‐term mortality and quality of life after transcatheter aortic valve replacement

Narayanan

Malik

Mbai

et al. 2019

Cathet Cardio Intervent

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Background: There is conflicting data as to whether diastolic dysfunction (DD) affects the prognosis of patients with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). Methods: Consecutive patients undergoing TAVR underwent assessment of DD with preoperative echocardiography and NT-pro BNP. Long-term survival was ascertained every 6 months by clinic visits or phone. DD was graded according to the new American Society of Echocardiography recommendations. Health status was assessed at baseline and 30 days post-procedure using the KCCQ-12 questionnaire. Long-term survival was displayed using Kaplan-Meier curves according to NT-pro BNP levels and DD grades. Results: We included 222 patients, mean age 78 (±8) years, median STS score 4 (interquartile range = 3-7), median follow-up time 385 days (IQR = 180-640). DD was absent in 25, Grade I in 13, Grade II in 74, Grade III in 24, and indeterminate in 86 patients.Advanced (Grades II-III) DD was associated with higher pre-procedural NT-pro BNP levels (p < .001), worse quality of life (p < .001) but similar surgical risk (p = .43). Advanced and indeterminate DD were associated with increased long-term mortality (25-28% vs. 5%, p = .02) and elevated NT-pro BNP levels (26.4% vs. 9.8%, p = .05). Improvements in quality of life measures were seen in all DD groups (median change in KCCQ score no or Grade I DD:14 [3-21] vs. Grades II-III DD: 15 [16-26; p = .37]).Conclusion: Preoperative NT-pro BNP levels and echocardiographic indices of indeterminate or advanced DD are associated with increased long-term mortality after TAVR but similar improvements in quality of life.

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Section: Discussionsupporting

confidence: 92%

Impact of diastolic dysfunction on long‐term mortality and quality of life after transcatheter aortic valve replacement

Narayanan

Malik

Mbai

et al. 2019

Cathet Cardio Intervent

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“…To provide a simple, exploratory analysis, we performed survival classification and regression tree (CART) analysis using the primary end point as an outcome variable, with preprocedural musclin levels as an independent variable. 19 , 20 , 21 , 22 The purpose was to identify the cutoff value of musclin for the risk stratification of the primary end point. 23 Next, we divided the study population into 2 groups based on this analysis.…”

Section: Methodsmentioning

confidence: 99%

Low Circulating Musclin is Associated With Adverse Prognosis in Patients Undergoing Transcatheter Aortic Valve Implantation at Low‐Intermediate Risk

Kattih

Carstens

Boeckling

et al. 2022

JAHA

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Background Musclin is an activity‐stimulated and cardioprotective myokine that attenuates pathological cardiac remodeling. Musclin deficiency, in turn, results in reduced physical endurance. The aim of this study was to assess the prognostic value of circulating musclin as a novel, putative biomarker to identify patients undergoing transcatheter aortic valve implantation (TAVI) who are at a higher risk of death. Methods and Results In this study, we measured systemic musclin levels in 368 patients undergoing TAVI who were at low to intermediate clinical risk (median EuroSCORE [European System for Cardiac Operative Risk Evaluation] II: 3.5; quartile 1–quartile, 2.2%–5.3%), whereby 209 (56.8%) patients were at low and 159 (43.2%) were at intermediate risk. Median preprocedural musclin levels were 2.7 ng/mL (quartile 1–quartile 3, 1.5–4.6 ng/mL). Musclin levels were dichotomized in low (<2.862 ng/mL, n=199 [54.1%]) or high (≥ 2.862 ng/mL, n=169 [45.9%]) groups using cutoff values determined by classification and regression tree analysis. The primary end point was 1‐year overall survival. Patients with low circulating musclin levels exhibited a significantly higher prevalence of frailty, low albumin values, hypertension, and history of stroke as well as higher N‐terminal pro‐B‐type natriuretic peptide. Low musclin levels significantly predicted risk of death in univariable (hazard ratio, 1.81; 95% CI, 1.00–3.53 [ P =0.049]) and multivariable (adjusted hazard ratio, 2.45; 95% CI, 1.06–5.69 [ P =0.037]) Cox regression analyses. Additionally, low musclin levels in combination with conventional EuroSCORE II suggested improved risk stratification in patients undergoing TAVI who were at low to intermediate clinical risk into subgroups with reduced 1‐year survival rates by log‐rank test ( P for trend=0.003). Conclusions Circulating musclin is an independent predictor of 1‐year overall survival in patients undergoing TAVI. Combined with EuroSCORE II, circulating musclin might help to improve prediction of mortality in patients undergoing TAVI who are at low to intermediate clinical risk.

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“…The inclusion criteria of this registry were previously reported. 6,7 All patients were treated with TAVR based on the clinical consensus of a heart team comprised of cardiac surgeons, interventional cardiologists, and anesthesiologists. Between October 2013 and May 2017, 2588 TAVR patients were registered in the OCEAN-TAVI registry.…”

Section: Study Population and Designmentioning

confidence: 99%

Late Progression of Tricuspid Regurgitation After Transcatheter Aortic Valve Replacement

Muraishi¹,

Tabata

Shibayama³

et al. 2022

Journal of the Society for Cardiovascular Angiography & Int

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Is elevation of N-terminal pro-B-type natriuretic peptide at discharge associated with 2-year composite endpoint of all-cause mortality and heart failure hospitalisation after transcatheter aortic valve implantation? Insights from a multicentre prospective OCEAN-TAVI registry in Japan

Cited by 4 publications

References 30 publications

Impact of diastolic dysfunction on long‐term mortality and quality of life after transcatheter aortic valve replacement

Impact of diastolic dysfunction on long‐term mortality and quality of life after transcatheter aortic valve replacement

Low Circulating Musclin is Associated With Adverse Prognosis in Patients Undergoing Transcatheter Aortic Valve Implantation at Low‐Intermediate Risk

Late Progression of Tricuspid Regurgitation After Transcatheter Aortic Valve Replacement

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